Low blood sugar (hypoglycaemia)

Hypoglycemia, or low blood sugar, occurs when blood glucose levels drop below 70 mg/dL (3.9 mmol/L). This condition can cause a range of symptoms and complications, especially in individuals with diabetes who are taking insulin or other blood sugar-lowering medications.

Symptoms

• Early Symptoms:

  • Shakiness
  • Sweating
  • Dizziness
  • Hunger
  • Rapid heartbeat
  • Irritability or moodiness
  • Anxiety

• Severe Symptoms:

  • Confusion
  • Blurred vision
  • Difficulty concentrating
  • Weakness or fatigue
  • Seizures
  • Loss of consciousness

Tests and Diagnosis

1. Blood Glucose Test: The primary method for diagnosing hypoglycemia involves checking blood sugar levels using a glucose meter.
2. Continuous Glucose Monitoring (CGM): For those with frequent hypoglycemia, CGM devices provide real-time glucose readings and trends.
3. Symptom Evaluation: A healthcare provider will assess symptoms in conjunction with blood sugar levels to diagnose hypoglycemia.

Causes

• Diabetes Medications: Insulin and certain oral diabetes medications can cause blood sugar levels to drop too low.
• Insufficient Food Intake: Skipping meals, not eating enough, or eating foods with insufficient carbohydrates.
• Excessive Alcohol Consumption: Alcohol can interfere with the liver's ability to release glucose into the bloodstream.
• Excessive Exercise: Increased physical activity can lower blood sugar levels, especially if not compensated with adequate food intake.
• Hormonal Imbalances: Conditions affecting hormone levels, such as adrenal insufficiency or hypothyroidism.

Types

• Reactive Hypoglycemia: Occurs a few hours after eating, typically due to an excessive insulin response.
• Fasting Hypoglycemia: Happens when not eating for extended periods, often related to medical conditions or medications.
• Drug-Induced Hypoglycemia: Caused by medications, particularly in people with diabetes.

Risk Factors

• Diabetes: Particularly type 1 diabetes and advanced type 2 diabetes treated with insulin or sulfonylureas.
• History of Hypoglycemia: Previous episodes increase the risk of future occurrences.
• Kidney Disease: Can affect how the body processes insulin and glucose.
• Older Age: Aging can affect the body’s response to hypoglycemia.

Prevention

• Regular Monitoring: Frequent blood glucose checks to detect and address low levels promptly.
• Balanced Diet: Eating regular, balanced meals with adequate carbohydrates.
• Medication Management: Adjusting medication dosages with the help of a healthcare provider.
• Avoiding Excessive Alcohol: Limiting alcohol intake and ensuring it’s consumed with food.

Treatments and Medication

1. Immediate Treatment: Consuming 15-20 grams of fast-acting carbohydrates, such as glucose tablets, juice, or regular soda.
2. Follow-Up Snack: Eating a snack or meal with protein and complex carbohydrates to stabilize blood sugar levels.
3. Emergency Treatment: In cases of severe hypoglycemia, administering glucagon via injection or nasal spray can raise blood sugar levels quickly.
4. Adjusting Medications: Under a doctor’s guidance, changing the dosage or timing of diabetes medications.

Natural Remedies

• Frequent Small Meals: Eating smaller, more frequent meals throughout the day to maintain stable blood sugar levels.
• Complex Carbohydrates: Incorporating whole grains, fruits, vegetables, and legumes that provide sustained energy.
• Healthy Fats and Proteins: Including healthy fats (avocados, nuts) and proteins (lean meats, beans) in the diet.

Complications

• Severe Hypoglycemia: Can lead to seizures, unconsciousness, and in rare cases, death if not treated promptly.
• Hypoglycemia Unawareness: Frequent episodes can blunt the body’s warning signs, increasing the risk of severe hypoglycemia.
• Impact on Daily Life: Fear of hypoglycemia can limit activities and reduce quality of life.

Supportive Care

• Education: Learning to recognize and respond to early signs of hypoglycemia.
• Support Network: Informing family, friends, and colleagues about the condition and how to help in an emergency.

When to See a Doctor

• Frequent Episodes: Regular occurrences of hypoglycemia should be discussed with a healthcare provider.
• Severe Symptoms: Any severe hypoglycemic episode or one requiring medical intervention warrants a doctor’s visit.
• Medication Adjustment: If current treatment plans are not adequately managing blood sugar levels.

Coping and Support

• Diabetes Education Programs: Participating in educational programs to better manage diabetes and hypoglycemia.
• Support Groups: Joining support groups to share experiences and strategies for managing hypoglycemia.

Caring for the Caregiver

• Knowledge and Preparedness: Caregivers should be informed about hypoglycemia symptoms and treatment.
• Self-Care: Ensuring caregivers also look after their own physical and emotional well-being.

Conclusion

Hypoglycemia is a manageable condition with proper education, lifestyle adjustments, and medical care. By understanding the causes, symptoms, and treatments, individuals with low blood sugar can lead healthy, active lives. Regular monitoring and communication with healthcare providers are essential to prevent and manage hypoglycemia effectively.